What you need to know about Ebola. Debunking the myths.

Summary: The hysteria about Ebola grows apace, fed mostly by those who profit from it (through status, publicity, clicks, or sales). Information is the antidote. Here we have experts telling us the key facts about Ebola, and debunking some of the most incendiary myths.

Ebola: it’s coming for you!

Contents

Status report: good news and bad

Debunking the Ebola myths

A far greater threat than Ebola

Other posts about Ebola

Where to go for information about Ebola

A history of pandemics

(1) Status report: good news and bad

If the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Friday 17 October. Likewise, Nigeria is expected to have passed through the requisite 42 days, with active surveillance for new cases in place and none detected, on Monday 20 October.

… In Guinea, Liberia, and Sierra Leone, new cases continue to explode in areas that looked like they were coming under control. An unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups. WHO epidemiologists see no signs that the outbreaks in any of these 3 countries are coming under control.

… For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance demonstrably in place, supported by good diagnostic capacity, and with no new cases detected. Active surveillance is essential to detect chains of transmission that might otherwise remain hidden.

The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.

A total of 8,399 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in seven affected countries up to the end of 8 October. 8,376 (99.%) were in Guinea, Liberia, & Sierra Leone. Four other nations have cases imported from them. Twenty in Nigeria, One each in Senegal, Spain, & USA.

There have been 4,033 deaths. 4,024 (99.7%) were in Guinea, Liberia, & Sierra Leone. Eight in Nigeria; one in USA.

Compared with most common diseases, Ebola is not particularly infectious. The primary risk of catching Ebola comes from the bodily fluids of people who are visibly infected – primarily their blood, saliva, vomit and (possibly) sweat. These can transmit the disease if they make contact with the mucus membranes (lining of your nose, mouth, and similar areas).

The Ebola virus is transmitted among humans through close and direct physical contact with infected bodily fluids, the most infectious being blood, faeces and vomit. …

Ebola virus disease is not an airborne infection. Airborne spread among humans implies inhalation of an infectious dose of virus from a suspended cloud of small dried droplets. This mode of transmission has not been observed during extensive studies of the Ebola virus over several decades. … Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.

Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus – over a short distance – to another nearby person. This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.

WHO is not aware of any studies that actually document this mode of transmission. On the contrary, good quality studies from previous Ebola outbreaks show that all cases were infected by direct close contact with symptomatic patients.

Moreover, scientists are unaware of any virus that has dramatically changed its mode of transmission. For example, the H5N1 avian influenza virus, which has caused sporadic human cases since 1997, is now endemic in chickens and ducks in large parts of Asia. That virus has probably circulated through many billions of birds for at least two decades. Its mode of transmission remains basically unchanged.

Speculation that Ebola virus disease might mutate into a form that could easily spread among humans through the air is just that: speculation, unsubstantiated by any evidence.

News that a nurse in full protective gear had become infected with the Ebola virus raised some disturbing questions on Monday. Has the virus evolved into some kind of super-pathogen? Might it mutate into something even more terrifying in the months to come? Evolutionary biologists who study viruses generally agree on the answers to those two questions: no, and probably not.

The Ebola viruses buffeting West Africa today are not fundamentally different from those in previous outbreaks, they say. And it is highly unlikely that natural selection will give the viruses the ability to spread more easily, particularly by becoming airborne. “I’ve been dismayed by some of the nonsense speculation out there,” said Edward Holmes, a biologist at the University of Sydney in Australia. “I understand why people get nervous about this, but as scientists we need to be very careful we don’t scaremonger.”

… Evolutionary biologists see no evidence that new mutations in the Ebola virus are responsible for the huge size of the current outbreak. “It’s far more plausible that the difference is that it’s gotten into a different human population,” Dr. Rambaut said. Instead of being limited to remote villages, the virus ended up in cities like Freetown, Sierra Leone, and Conakry, Guinea. The combination of a big population of hosts and a medical system unable to control the infection has led to an epidemic. “You’ve got a fairly standard Ebola virus,” Dr. Holmes said. “It’s just in the worst possible place.”

… Over the course of millions of years, viruses do sometimes switch their route of infection. “It does happen in an evolutionary context,” Dr. Holmes said. But it would be a mistake, he warned, to imagine that with a single mutation Ebola might become an airborne pathogen. The change would require many mutations in many genes, and it might be nearly impossible for so many mutations to emerge during a single outbreak. The mutated viruses would survive only if they were superior to the ones spread by bodily fluids. “The virus is doing pretty well right now,” Dr. Holmes said. “So it would need to be beneficial for the virus to make this quite big jump.”

Dr. Rambaut agreed that the odds were exceedingly low. “Viruses generally don’t change to that radical degree,” he said.

Dr. Sabeti said, “It is biologically plausible, but very unlikely.”

(3) About a far greater threat than Ebola

A flu virus isn’t particularly complex; it’s just a stretch of RNA transmitted between animals, human and nonhuman, that has evolved to mutate quickly enough to outpace any long-term immunity. But one stretch of RNA can wreak a lot of havoc. Spanish influenza killed about 50 million people (estimates vary), including 675,000 in the United States, and up to 40% of the world’s population was stricken with the flu.

… Spanish flu was a pandemic of a different magnitude compared to swine flu, bird flu, or any other recent outbreaks. And perhaps because of its worldwide prevalence, it became the foundational flu of modern times. Before 1918, another influenza virus was surely being passed from human to human. When Spanish flu emerged, it out-competed this virus, mutating with greater celerity and spreading with ease. And though it has since mutated further, Spanish flu remains the basic strain of influenza being spread today. If you had swine flu, or even a standard-grade seasonal flu, you almost certainly contracted a mutation of Spanish flu.

… The problem comes along when a completely new influenza virus emerges, one that knocks Spanish flu off its throne. … “You can say with almost complete certainty that humans will face future pandemics of influenza,” Taubenberger said. “And at the moment, we can’t predict them in advance.”

(5) Reliable information about Ebola

“How calm can counter Ebola“, editorial in the Christian Science Monitor, 3 August 2014 — “Health officials say they must act as much to calm fears of Ebola as to contain the outbreak. Media-driven hysteria about Ebola doesn’t help.”

(6) A history of pandemics

With Africa reeling from the recent Ebola outbreak, global attention is focused squarely on the danger of an uncontrollable outbreak of disease. In this interactive piece, we look at the world’s deadlist outbreaks, as well as history’s most dangerous diseases.

Click on the title to see the interactive graphic. Use the scroll bar at the top to view the history of outbreaks, or click any of the diseases at the bottom for more info.

12 thoughts on “What you need to know about Ebola. Debunking the myths.”

‘Nurses are not protected, they’re not prepared for Ebola’: Angry nursing union says NO US hospital can cope – and claim hazardous waste was piled to the CEILING of Thomas Eric Duncan’s room.

Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and the nurses treating him worked for days without proper protective gear and faced constantly changing protocols, according to a statement released late Tuesday by the largest U.S. nurses’ union.

Nurses were forced to use medical tape to secure openings in their flimsy garments, worried that their necks and heads were exposed as they cared for a patient with explosive diarrhea and projectile vomiting, said Deborah Burger of National Nurses United. Burger convened a conference call with reporters to relay what she said were concerns of nurses at Texas Health Presbyterian Hospital, where Thomas Eric Duncan — the first person to be diagnosed with Ebola in the U.S. — died last week.

… RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She refused to elaborate.

Among the nurses’ allegations was that the Ebola patient’s lab samples were allowed to travel through the hospital’s pneumatic tubes, opening the possibility of contaminating the specimen delivery system. The nurses also alleged that hazardous waste was allowed to pile up to the ceiling. …

My guess is that this is posturing for TV. Not unlike the exaggerated (often false) claims made by police after the Ferguson shooting.

Waste was piled because the disposal service would not take it until it was sterilized. Piling the low-level waste in a secured room does not seem inappropriate.

This does remind us that in a crisis some experts will build reputations with wild statements. We see this with the extreme forecasts of a few climate scientists (unsupported by anything in the peer-reviewed literature), and after Fukashima.

This level of focus on Ebola is nuts. The focus of so many Americans on this is more evidence that the missing link is from our heads. There are so many serious problems –.in which we can make a difference — that we ignore in preference to watching what is in effect a sideshow.

How many people die in gun-related deaths every day in America? Every month the government slices away a bit more of our liberty. Our disparate search for distractions from our responsibilities is sad, even pitiful.

I do not watch broadcast or cable news, hence I do not get the same sense that the world is collapsing as others seemingly are.

However, I am concerned about the CDC’s demonstrated lack of candor and competence. It seems that they think their primary mission is to calm the proles instead of controlling disease, and are putting out happy-talk.

Even before photos were published of unprotected workers pressure-washing Duncan’s vomit off the sidewalk (nice aerosol!) and a woman with sandals walking through the runoff (http://bit.ly/1x4A45r), the hospital initially sent his family back there (lack of coordination?), and it still took the CDC days to clean out patient zero’s infected apartment. They then blamed the nurse (patient #2) when in fact their protocol may be defective.

So far the actions of the CDC are not inspiring confidence. Like so much of the D.C. ruling class, they seem more concerned with CYA than putting out accurate information. Similar to the NSA scandal. “You stupid peasants are too dumb/excitable/emotional (pick one) to handle the truth; therefore, we will tell you what is only necessary for you to know.”

The Texans were incompetent in other ways. Exposed people because of incompetence, so I expect, maybe they will find other people who test for ebola. Did you see that judge walk into infected apartment?

The problem is that nurses and doctors have gotten it despite being protected. This could be because of mistakes we do not know about or it is transmitted through the air.

I would love to see the people accusing others of “incompetence” judged by such high standards in their own lives. My guess is that very very few would measure up. When I see someone doing so, that personI will listen to. The rest of you, not so much.